Implications of extubation failure and prolonged mechanical ventilation in the postoperative period following elective intracranial surgery

Implications of extubation failure and prolonged mechanical ventilation in the postoperative period following elective intracranial surgery

Autor Vidotto, Milena Carlos Autor UNIFESP Google Scholar
Sogame, Luciana Carrupt Machado Autor UNIFESP Google Scholar
Gazzotti, Mariana Rodrigues Autor UNIFESP Google Scholar
Prandini, Mirto Nelso Autor UNIFESP Google Scholar
Jardim, José Roberto Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Santa Casa de Misericórdia de Vitória Escola Superior de Ciências Departamento de Fisioterapia
Resumo Patients undergoing neurosurgery are predisposed to a variety of complications related to mechanical ventilation (MV). There is an increased incidence of extubation failure, pneumonia, and prolonged MV among such patients. The aim of the present study was to assess the influence of extubation failure and prolonged MV on the following variables: postoperative pulmonary complications (PPC), mortality, reoperation, tracheostomy, and duration of postoperative hospitalization following elective intra-cranial surgery. The study involved a prospective observational cohort of 317 patients submitted to elective intracranial surgery for tumors, aneurysms and arteriovenous malformation. Preoperative assessment was performed and patients were followed up for the determination of extubation failure and prolonged MV (>48 h) until discharge from the hospital or death. The occurrence of PPC, incidence of death, the need for reoperation and tracheostomy, and the length of hospitalization were assessed during the postoperative period. Twenty-six patients (8.2%) experienced extubation failure and 30 (9.5%) needed prolonged MV after surgery. Multivariate analysis showed that extubation failure was significant for the occurrence of death (OR = 8.05 [1.88; 34.36]), PPC (OR = 11.18 [2.27; 55.02]) and tracheostomy (OR = 7.8 [1.12; 55.07]). Prolonged MV was significant only for the occurrence of PPC (OR = 4.87 [1.3; 18.18]). Elective intracranial surgery patients who experienced extubation failure or required prolonged MV had a higher incidence of PPC, reoperation and tracheostomy and required a longer period of time in the ICU. Level of consciousness and extubation failure were associated with death and PPC. Patients who required prolonged MV had a higher incidence of extubation failure.
Palavra-chave Neurosurgery
Craniotomy
Ventilator weaning
Intratracheal intubation
Postoperative period
Idioma Inglês
Data de publicação 2011-12-01
Publicado em Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 44, n. 12, p. 1291-1298, 2011.
ISSN 0100-879X (Sherpa/Romeo, fator de impacto)
Publicador Associação Brasileira de Divulgação Científica
Extensão 1291-1298
Fonte http://dx.doi.org/10.1590/S0100-879X2011007500146
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000297766300014
SciELO S0100-879X2011001200014 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/6789

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